A lot, according to a slew of recent studies that have linked gum disease, or periodontitis, to an increased risk of heart disease. The connection made sense, since the two conditions share common drivers, such as inflammation. One theory held that inflammation or infection that starts in the mouth could spread to other parts of the body. But the American Heart Association (AHA) says the data connecting gum and heart health aren’t as strong as experts had thought.

It turns out that most such studies were not the rigorous clinical trials that first measure dental health and then compare it to subsequent heart issues. Rather they were observational studies. That is, they established an association, but not a cause. So while gum disease and heart disease may occur together, it’s possible that some of that association could be due to confounding factors that raise the risk of both conditions, such as smoking, obesity and poor overall health.

“There have been very few attempts to look at periodontal disease and heart disease in a definitive fashion,” says Peter Lockhart, co-chair of the AHA committee that reviewed the evidence. “And the ones that were done were not always comparing apples with apples.”

The committee reviewed 537 studies investigating periodontal disease and heart conditions including heart attack, atherosclerosis and stroke. Some showed a positive association between dental infections, which are caused by bacteria invading the space between the gums and teeth, and heart problems, while others showed no correlation. Taken together, Lockhart says the data don’t support a causal relationship between gum disease and heart disease.

The AHA published a scientific statement in the journal Circulation summarizing the existing evidence, saying, “Observational studies to date support an association between periodontal disease and atherosclerotic vascular disease independent of known confounders. They do not, however, support a causative relationship.” In addition, the group says there is no evidence that treating periodontal disease can lower the risk of heart problems.

That doesn’t mean that people shouldn’t treat their gum disease or that dental problems have no effect on the heart; it’s just that it’s too soon to say that periodontal disease can trigger heart attacks. Lockhart says the statement should help people to focus their attention on the established risk factors for heart disease, including smoking, obesity, high blood pressure and elevated cholesterol levels, and by doing so, hopefully lower their risk of disease.

A BETTER HYPOTHESIS TO EXPLAIN THE OBSERVED STATISTICAL ASSOCIATION BETWEEN GUM DISEASE AND CARDIOVASCULAR DISEASE IS AS FOLLOWS:

I had the experience of catching a nasty respiratory virus (very likely a coxsackievirus B), which also spread around my social group.

THIS VIRUS THEN PRECIPITATED BOTH GUM DISEASE AND CARDIOVASCULAR PROBLEMS in several of the people who were infected by it.

Having observed how this virus rapidly caused both periodontal and cardiovascular problems (specifically: heart attacks, myocarditis and pericarditis) in several infected individuals, I would suggest that rather than the now debunked hypothesis of oral bacteria migrating from the gums to the heart and therein causing cardiovascular damage, a much better explanatory hypothesis is that A CHRONIC VIRAL INFECTION CAUSES BOTH PERIODONTAL AND HEART DISEASE SIMULTANEOUSLY.

That is to say: gum disease does not directly cause cardiovascular disease; rather a chronic viral infection is the singular etiological underpinning of both, and this single viral cause explains why gum disease is statically associated with cardiovascular disease.

Coxsackievirus B in infection is known to cause heart attacks, myocarditis and pericarditis; and viral infections can undermine and degrade the connective tissue of the gums by the fact that such infections can generate connective tissue-degrading enzymes (like MMP-9 and others).